Provider Demographics
NPI:1922291624
Name:LEE, STEPHANIE (PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 JENNINGS MILL RD UNIT 3200B
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7282
Mailing Address - Country:US
Mailing Address - Phone:706-621-3024
Mailing Address - Fax:
Practice Address - Street 1:1551 JENNINGS MILL RD UNIT 3200B
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7282
Practice Address - Country:US
Practice Address - Phone:706-621-3024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-26
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003118103TC0700X, 103TC0700X
AL1632103TC0700X
VA0810004555103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical